Provide primary health care for street children

Childhope Philippines continues its drive to eliminate intestinal parasitism in street children of Metro Manila. The Childhope’s Mobile Health Project in partnership with school volunteers are distributing anti-helminthic drugs during the National Deworming Month (NDM) campaign of Department of Health, held last December 19, 2018 at Museo Pambata, Manila.

Deworming is being done because Soil Transmitted Helminths (STH) is a public health problem that has detrimental impact on children’s growth and development. STH can cause anemia, malnutrition, weakness, impaired physical and cognitive development resulting to poor growth and school performance in children.

The magnitude of the problem of STH showed that 6 out of 10 pre-school children ages 1-5 years old (baseline prevalence of 66%) (2004, DOH-UP-UNICEF) and 5 out of 10 children (54%) aged 6-14 years old (2003, UP-CPH) were affected with STH. Recent data also showed that the overall prevalence of STH among school-age children is 28.4% with 13 Regions still having prevalence of more than 20% (DOH-RITM National Parasite Survey, 2013-2015).

The World Health Organization (WHO) set the target that at least 75% deworming coverage should be attained but the Department of Health has a higher target which is 85%.

Last December, the deworming coverage among 30 street children under the assistance of Childhope Philippines has been dewormed.

“Childhope Philippines together with its partners and volunteers continues the initiative of conducting the deworming to achieve our goal in reducing the prevalence of Soil Transmitted Helminths in the country to less than 20% by 2022 to prevent its detrimental impact on children’s health and education if not properly addressed or treated.” Mobile Health Project Officer, Dr. Josefina Carpio stated.

University of the East Ramon Magsaysay Memorial Medical Center, Inc., who has sent volunteers and has donated 1,500 tablets of Mebendazole which will be used to deworm all five to fourteen year old street children under the Mobile Health Program of Childhope Philippines.

“It’s our commitment to foster a healthy community that will address public health challenges like the STH, with a goal to improve health and nutrition of impoverished children in the country,” said Ralph Lorenz apilado, UERM Volunteer

”We ask for the support of the parents and guardians to support this great endeavor. The success of this campaign relies profoundly with the support and actions of the non-government organizations, developmental partners and the local government units. With this unified effort, health for all will be achieved” Dr. Carpio concluded.

For more than a decade, the Mobile Health Clinic (MHC) van of Childhope Philippines provides much needed health and medical services to street children all over Metro Manila. Since it’s maiden run in 2007, the MHC van already served more than 5,000 street children through a full-time medical doctor providing regular health check-ups, management of illnesses and preventive primary health care.

“The clinic van already showed signs of wear and tear and needed some repairs to be able to continue helping us provide for the health needs of the children, especially in those areas where public health clinics are inaccessible,” said Dr. Josefina Pamela Carpio, project officer and physician of The Mobile Health Clinic Project. “Through the MHC van, we make health care more accessible for the street children and their families,” she added.

“The facelift is a symbol of our continued commitment towards service for the children in need. We do not only make sure that they get more opportunities for education and welfare, but we also take care of their health while they study under our program. After all, health and education always go hand in hand. You will have a hard time educating a sickly child,” said Dr. Herbert Quilon Carpio, Executive Director of Childhope Philippines.

Along with much needed repairs, the van will now be dubbed Klinikalye or Clinic on the streets, giving it a distinct identity.

The MHC van was given to Childhope through a matching grant by the Rotary Club of Paco and Rotary Club of Honolulu, and has been provided support by partner organizations and donors from GlobalGiving for the past years.

About eighteen new Junior Child Rights Advocates participated, led by Childhope’s Assistant Executive Director, Ms. Helen Quinto, and with Mr. Ralph Ivan, President of Y-Peer Philippines as trainor.

The aim of the training is to strengthen the skills of the participants and to provide them with a basic knowledge on the current situation on HIV and AIDS in the Philippines, as well as interactive methods on how to improve their sensitization and counselling skills and how they can engage with their fellow youths during similar activities to create HIV awareness.

“The training will equip the advocates with knowledge and awareness about HIV, AIDS, and STI, and on child rights and gender equality as well,” Quinto said.

The training also focused on the different aspects of peer education and counselling prior to HIV testing as a first step to HIV prevention.

“In HIV prevention, we should be aware that testing is crucial to providing access to early treatment and care for people living with HIV and to protect those who are HIV negative,” Ivan said.

Childhope Philippines capacitates these youngsters to be more knowledgeable by providing them integrated education, and be more a responsible youth by sharing their learnings to fellow youth, family, and community.

Moreover, as part of Childhope Philippines’ holistic alternative education sessions, modules on STI-HIV/AIDS prevention, adolescent sexuality and reproductive health, as well as gender sensitivity and gender equality are conducted among older street children and youth.

A group of fourth year medical students from the Ateneo School of Medicine and Public Health (ASMPH) went out of the hospital and into the streets of Metro Manila to conduct alternative education sessions on Environmental Health for the beneficiaries of Childhope Philippines.

Childhope Philippines, a non-profit organization and the pioneer of street education in the country, has been teaching street children about their rights, health, protective behavior, and basic literacy and numeracy, armed with ten Alternative Education modules and a hardworking team of Street Educators.

Environmental Health is a welcome and long-awaited eleventh module, pushing Childhope to the present as it tackles a very important issue concerning not only the country but the entire world.

This is a two-year project of the medical students as part of ASMPH’s Learning Experiences in Communities, and was meticulously developed under the supervision of Childhope’s Physician.

The students’ two-week community rotation was the culmination of their LEC, where they taught street children from Lawton, Divisoria, and Monumento, that one’s own personal health and the health of our environment are very important and very much interconnected.

Childhope’s approach to health stays true to the Declaration of Alma Ata, which defines health as the “complete physical, mental, and social wellbeing, and not merely the absence of disease or infirmity.” The Mobile Health Clinic played a vital role in ensuring that Childhope’s street children beneficiaries had access to health services, ensuring that they are healthy enough to attend formal and non-formal education. However, the impact of the other social determinants of health clearly demonstrated that the Mobile Health Clinic cannot stand alone in ensuring the health and wellbeing of our beneficiaries. Through Childhope’s Street Educators, our beneficiaries learned basic knowledge and skills, including primary health care, to survive in the streets and to eventually leave the streets for a better and more productive life. They received basic education through basic literacy and numeracy classes, alternative learning system (ALS) classes, and vocational and technical skills training. Childhope’s Social Workers, on the other hand, provided psychosocial intervention that targeted problems that our street children may have had with their families, the community, the school, and with the law. With the three main arms of Childhope’s Street Education Program working hand in hand, our street children beneficiaries were ensured a fighting chance to become respected and responsible members of the society now and in the future.

The major challenge Childhope faced in the implementation of the Mobile Health Clinic Project was the continued “rescues” or round-up operations of street dwellers by the local government. These rescues, although done regularly, were intensified during international events held in Metro Manila. Ideally, the rescued street dwellers are dropped off in processing centers and immediately reunited with their families or transferred to long-term residential facilities for proper case management. Although theoretically beneficial for street dwellers, and for street children in particular, the implementation was still far from ideal. As a result, the street children just got in and out of the center several times, disrupting Childhope’s health, education and psychosocial services they receive while under our care. To manage this problem, the Social Workers intensified their coordination with the residential centers to endorse the cases of our beneficiaries and ensure the continuity of services. For health in particular, beneficiaries with medical concerns were provided with medical assistance and regularly followed-up to safeguard their health while in the custody of residential facilities until such time that the street children are reunited with their families, or the residential facilities can fully take-over the case management.

During the one-year implementation of th Mobile Health Clinic Project, one thousand one hundred and thirty four (1134) medical consultations were conducted with street children beneficiaries inside the Mobile Health Clinic. Exactly two hundred and sixty (260) of these were Well Child consults, accounting for twenty two percent of all consultations. Majority, or approximately 75%, of the children seen and examined were well-groomed, as much as their living conditions allowed them to, exhibiting good personal hygiene practices they learned through primary health care sessions with our street educators and additional health sessions by the Junior Health Workers. During medical consultations, our beneficiaries received medical assistance, such as complete course of medicines, vitamin and mineral supplements, wound care, and minor surgical procedures inside the Mobile Health Clinic, as well as diagnostic tests, consultations with specialists, and emergency referrals that were carried out by the social workers.

The nutritional status monitoring this year showed that eighty percent (80%) of our street children beneficiaries were within the normal range based on the World Health Organization’s Growth Standards. On the other hand, nine percent (9%) were underweight, eight percent (8%) were overweight, and three percent (3%) were obese. All our beneficiaries were advised about good food choices during one-on-one medical consultations, and were routinely given vitamin and mineral supplements to ensure that they receive the micronutrients they otherwise lack due to their limited food supply. Routine deworming was conducted in all the areas (100%) where Childhope operates to ensure that our beneficiaries do not suffer from further malnourishment due to intestinal parasites.

Several medical referrals were carried out. Thirteen (13) children underwent various diagnostic tests for further evaluation of their medical problem, and twelve (12) children were referred to medical specialists or to the emergency room. Two of the latter were referred for anti-rabies and anti-tetanus vaccination because of dogbite. Two children were brought to the Child Protection Unit due to separate incidents of mauling. An educational scholar was referred to an Ophthalmologist due to a sudden onset of blurred vision and strabismus (or being cross-eyed), and was treated for Optic Neuritis. An adolescent boy was admitted to the hospital due to difficulty of breathing, and was treated for Pulmonary Tuberculosis. A teenage girl was admitted for surgical excision a Nabothian cyst, a cyst within the genital tract. Four children were referred to an Optometrist due to blurring of vision, and were subsequently provided with corrective eyeglasses. Lasty, a boy was referred to the emergency room for probable leg fracture, but was cleared of it by the attending Orthopedic Surgeon. Unfortunately, one child refused to undergo the needed diagnostic tests despite repeated counselling, but the social worker in charge of him is exploring other options for care.

The Junior Health Workers were instrumental in multiplying the number of beneficiaries provided with health services. The JHWs provided first aid and wound care one thousand one hundred and fifteen times (1115) to their fellow street children and other members of their respectve communities, assisted three hundred and thirty five (335) children in personal grooming, and conducted one-on-one health sessions regularly to a total of four hundred and twenty nine (429) beneficiaries.

It is worth noting that for this year, there were no documented cases of complications, disabilities, and deaths, due to delayed treatment or medical negligence.

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